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Improving Long-Term Outcomes in Adolescent Adoption

Adoption Advocate No. 148

In 2019, 23 percent of all children in foster care were 13-17 years old, and nearly 6 percent of those were adopted that same year.1 While international adoptions have declined overall since 2005, the percentage of adolescents ages 13-17 adopted internationally climbed from 2.8 percent to 16.4 percent between 2005 and 2019.2 With organizations intentionally focusing on reducing the number of youth in care and agencies diligently recruiting families to adopt older children, an increasing number of families are considering adopting older children. Encouraging families to adopt older children is good child welfare policy and the right option for many families and children. Unfortunately, recent outcomes have made it clear that some families are not being adequately prepared for parenting older adopted children. In the face of challenging behaviors, families struggle to see beyond the hard outer shell to the preciousness of a child whose behavior often stems from difficult past experiences. When parents are provided with specialized knowledge, skills, and ongoing support to respond to these behaviors, the child has the opportunity to thrive in a nurturing, permanent family.

This article identifies critical gaps in adoptive parent education and provides recommendations for professionals who recruit, prepare, and support families who adopt adolescents. The authors conducted surveys and interviews with 40 families who adopted adolescents either domestically or internationally, and authored Wisdom from Adoptive Families: Joys and Challenges in Older Child Adoption based on their findings. Gleaning from their professional work and personal experience with adolescent adoption, and ongoing work in child and family therapy, the authors seek to illuminate opportunities to significantly improve the long-term outcomes for strong adoptive families.

Pre-Adoption Parent Education Tailored to the Unique Needs of Adolescent Adoption

Parents who adopt adolescents learn that traditional parenting practices and systems of consequences and rewards are often ineffective at bringing about long-term behavioral change with older adopted children. As a result of the trauma and adversity they have experienced, these adolescents often struggle to see the connection between actions and consequences, and often view rewards as only temporary motivators.3 Parents need help obtaining more effective resources and learning new parenting strategies as these challenges increase stress in the home and can threaten family stability, potentially leading to dissolution.

Self-Reliant Behavior

Prospective adoptive parents benefit from training that emphasizes how adolescents in care often learn to be self-reliant and depend on no one. Children in care learn their survival has been contingent on parenting and protecting themselves and their ability to meet their own needs. Many have developed unhealthy relationships in their former placements (e.g., inappropriate exchange of goods or favors, contactless and/or physical sexual abuse, etc.) as a means of self-protection or to safeguard their personal belongings because they have lived in a constant state of survival. Additionally, some older children have been responsible for younger siblings or other children in their former placements, creating unhealthy self-reliant and parentified behaviors which do not immediately go away the moment they have caring, permanent parents. Professionals can help parents understand and expect that it takes time for children and youth to release unhealthy habits and to feel safe, loved, and seen. Parents’ understanding, unconditional acceptance, and patience during this time are vital to the permanency of the placement.

Grief and Loss

Adoption education that effectively teaches parents about the series of losses that children adopted as adolescents experience is critical.4 While significant emphasis is placed on the initial loss of a child’s birth family, it is important also to acknowledge the subsequent losses children experience through multiple placements as many older children in foster care may have been moved every few months.5 Even after being adopted, children may falsely expect another move at any time and for any or no reason—change may have been their only constant. Children adopted internationally may have experienced frequent change of caregivers, even those to whom they may have formed an attachment. They may have been moved to and from foster homes, medical homes, and child welfare institutions. They experienced the additional loss of their birth country and perhaps their original language.

Although it is often unacknowledged, many children—adopted internationally and domestically—also experience a loss of their culture. Children from inner-city communities and cultures may be adopted or fostered by families living in suburban or rural communities. Moving from apartment living, where many children their age gather, to their new sprawling suburban or rural environments can heighten feelings of loneliness and isolation. Further, their adoptive family may be of the same ethnicity but hold a completely different perspective on the world with vastly different expectations, beliefs, and frames of reference. Parents must understand and be equipped to identify how grief and loss impact their child, and how they manifest in their child’s behaviors, thinking, and daily life.

Inconsistent Norms

Similarly, these children often enter placements with a different set of norms. They may be used to eating on the couch all the time, using electronics in excess, cussing, or not participating in household chores, which may be unacceptable behaviors to their adoptive parents. They experience discomfort not knowing the expectations and may be hyper-vigilant as they attempt to determine what is normal and expected of them in each placement. With frequent change, these children often experience an ongoing state of confusion, frustration, and resentment.

Developmental Delays & Attachment Difficulties

Seasoned adoptive parents note that prospective adoptive parents should receive clear training about developmental delays, and how likely and often complex they are in adolescent adoption. Parents must realize that slower and regressed development is an appropriate response to trauma. In fact, some developmental delays are “normal” responses to experiencing abnormal and traumatic events at a young age. Professionals can direct parents to the growing network of publications on trauma, effective parenting approaches, and classroom interventions6,7,8 as well as information for extended family and friends. Parents should also know there are trauma-informed, trust-based relational intervention (TBRI®) certified9 and attachment-based therapists and counselors available to serve this population, with many offering virtual or telehealth options.

Prospective families also need to learn from professionals, with specialized attachment training, how to recognize and address attachment difficulties in older children.10 Parents adopting an adolescent should have differentiated curriculum from those adopting a toddler or elementary age child . Before placement, families need actionable ideas on how to facilitate attachment with adolescents. Unfortunately, common practice frequently teaches attachment techniques more appropriate for younger children. Often adolescents perceive these techniques as outlandish, which can inhibit trust and delay attachment. Since pre-adoption preparation and high family functioning have been positively linked to parent satisfaction,11 quality preparation is vital to family permanency.

Challenging Behaviors

Professionals typically help prospective adoptive families prepare for challenging behaviors such as lying, disrespect, manipulation, aggression, and stealing. However, families often fail to realize these negative behaviors often intensify—even after the child has been home for two or three years.12 Parents can feel overwhelmed by negative behaviors they witness, especially when they increase over time. Professionals can suggest several reasons these behaviors may worsen. The child may be struggling to process their present or past experiences. It could be that the child is attempting to make their environment match the tumultuous emotions they feel inside. They may be testing the parent relationship, or they may feel safe enough to genuinely express themselves. Offering therapeutic recommendations for the child, the parents, or the whole family can be beneficial and appreciated.


Adoption professionals should continue to encourage families to learn how to practice self-reflection and to implement other healthy coping mechanisms. The ability to routinely assess one’s own thoughts, emotions, and actions can be extremely helpful for families who have chosen adolescent adoption. Understanding that “no one can pour from an empty cup” gives parents permission to take care of themselves and their relationships, leading to higher family satisfaction and success.

Comprehensive Post-Adoption Supports & Services

Post-placement services need to be expanded and improved to give parents a better understanding of their child’s needs and raise awareness of resources that can improve children’s behaviors.13 Shortly after placement, if not before, families need a comprehensive list of resources such as local and national conferences, training videos, books, and blogs as well as in-person and online therapists and support groups.14,15,16 Services need to include resources to address common concerns for adolescent adoptees such as substance abuse,17 depression, self-harm (including self-mutilation), and eating disorders. Additionally, post-placement training on educational advocacy18 and sex education is recommended.

Professionals and the adoption community must work together to remove the stigma and shame of needing help post-placement. Agencies need to extend post-placement services and support beyond the minimum requirements as many families cannot accurately identify their needs until the child has been home two or more years.19 Moreover, services are more effective when “flexible, individualized, and available for an extended period of time.”20 Families need access to services that adapt to their individual needs (e.g., specific goals for the family, consultation and personalized training, or guidance and attendance at school and community meetings as requested by the family) as well as their changing needs over time (e.g., appropriate community resources, counseling, respite care, therapeutic camp, day treatment, or residential care). Although it may not be required, agencies should check in with families at least every six to eight months for a minimum of five years. These extended connections can offer guidance on how to address current issues and alert parents to potential dangers ahead such as holidays and anniversaries, or the child’s different developmental stages such as hitting puberty, dating, joining the work force, graduating, or moving out. Some families may additionally benefit from connecting with a mentor parent with a similar background (e.g., children of similar ages, cultures, or type of schooling – homeschool, private, or public).

Post-adoption respite services can prevent parent burnout and provide parents an opportunity to reflect and make plans to strengthen their support system. Families typically feel most supported by connecting with other adoptive families for respite and other support through local and online communities. Professionals can direct parents to both in-person and online groups to connect with other adoptive families, while realizing some find in-person connection most advantageous and others prefer the anonymity and access to adoptive families all over the world. It is crucial for professionals to emphasize the importance of protecting a child’s story and to encourage parents not to overshare in online communities. However, to provide necessary services, families and professionals must establish a trusting relationship by maintaining open, non-judgmental communication. Further, it is crucial for professionals to emphasize the importance of protecting a child’s story and to encourage parents not to overshare in online communities. Tragically, some parents in distress have even been deceived into turning over custody of their children, either temporarily or permanently, to predators who presented as a friend wanting to help. For some who believed the arrangement was only temporary, their children were kept away and in an unsafe environment. Professionals maintaining open, non-judgmental communication with families can establish a trusting relationship so families know they will receive help when needed.

Recommendations for Improved Recruitment and Placement Processes

Many improvements have been made to give permanence to adolescents in care, but more work remains. In addition to a call for more adolescent-specific adoption preparation, changes in current recruitment and placement processes can also yield better outcomes for children and families. While the need for more adoptive parents is substantial, not all who express a willingness should be selected. There needs to be a greater focus on finding appropriate families and ruling out families for whom adolescent adoption would not be a good fit. Professionals should identify why a family wants to pursue adolescent adoption, and the motives of prospective parents must be vetted rigorously in order to identify misplaced or wrong intentions. For couples, each partner needs to be fully committed. Neither should agree to make this commitment to please, or appease, the other. The decision to adopt should not be about a parent needing a child or giving an existing child a sibling. On the contrary, adoption is about finding the right family for a child. The purpose of adoption should not be to gain attention or to “save” a child. Even the very well-intended desire to open one’s home to a child is not, in and of itself, sufficient long-term motivation.

Adoption is about being fully committed to parent a child who needs a family. It is vital for parents to understand that their relationship with a child placed as an adolescent can differ significantly from a relationship they may have with a child placed at a younger age. It may take a few years to feel connected, and some may never feel a parent-child bond. The prospective parent’s personality impacts the success of a placement. For some parents, preparing the child for independent living will be their primary role.21 Those best suited for adolescent adoption are those who are flexible and willing to adapt to the child’s characteristics,22 and who accept that they cannot control a child’s behavior. Their parenting role is to help the child reach their full potential.

Professionals need to help parents accurately identify expectations they have for themselves, their child, their family, the adoption process, and for how life will be with a new child. Parents often report their expectations did not match reality. All known information about a child must be transparently and accurately shared with prospective parents so that they are fully informed and aware of all possibilities. Some parents share that their child had different medical conditions, interests, personality type, mental health issues, learning challenges, and behaviors than described by the adoption professional. Some families describe being given a “fairy-tale” version of their child’s history to encourage placement.23 Others believe their agency or caseworker withheld information about their child’s past to persuade them to move forward with the placement.24 Although most parents say they still would have proceeded, knowing the truth would have better prepared them for the challenges they experienced.25 Learning to accept a child for who they truly are can be difficult when families expected the child who was described to them. Parents who have more appropriate expectations about their child’s behavior report a more positive impact of the adoption on their family.26 Professionals can help establish more appropriate expectations by providing accurate and realistic descriptions of the child and sharing common adolescent adoption behaviors and needs.

With the increase in adolescent adoptions, critical gaps in the selection and preparation of families have been identified. Families continue to need more supportive services and resources. As new training programs are developed, families can better understand the unique needs in older child adoption. Quality preparation that includes providing parents with more effective resources and parenting strategies can improve children’s behaviors and the permanency of their placement. Thankfully, a greater emphasis on learning about the effects of trauma has led to utilizing special strategies to help families and children. Having appropriate expectations, long-term support, and self-care are vital to family stability. Parents’ understanding of where their child is coming from (e.g., self-reliance, grief and loss, inconsistent norms, developmental delays, and attachment difficulties), their unconditional acceptance of the child, and their patience will lead to a more positive impact on the family. Gaining wisdom and more compassion regarding these children and adoptive families will lead to more environments conducive to healing.

More from these Authors

The information in this article is based on the authors’ book, Wisdom from Adoptive Families: Joys and Challenges in Older Child Adoption, a resource for families exploring adolescent adoption or parenting a child who joined their family as an adolescent. Arranged topically, it offers wisdom from a variety of parental experiences because there is no one-size-fits-all approach in adolescent adoption. Drs. Kittle and Reed desire families who choose adolescent adoption to have realistic expectations in order to find satisfaction and success. The authors blog at and speak on a variety of topics. Their website also includes helpful resources for parents, families, schools, and professionals to increase their understanding of adopted children, improve family connection, prepare adolescents for adulthood, and find a specialist.

Suggested Resources


  1. U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau. (2020). The AFCARS Report (27). Retrieved from
  2. U.S. Department of State, Adoption Statistics (2020). Retrieved from
  3. U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children’s Bureau. (2015, April). Parenting your adopted teenager. Child Welfare Information Gateway. Retrieved from:
  4. Kittle, K. & Reed, K. (2017) Wisdom from adoptive families: Joys and challenges in older child adoption. Jacksonville, FL: Marcinson Press.
  5. Boys and Girls Aid. (n/d) Preventing the movement of children in foster care [Web log post]. Retrieved from:
  6. Sporleder, J. & Forbes, H. T., et al. (2016) The trauma-informed school: A step-by-step implementation guide for administrators and school personnel. Boulder, CO: Beyond Consequences Institute.
  7. Atallah, D. G., Koslouski, J. B., Perkins, K. N., Marsico, C., & Porche, M. V. (2019). An Evaluation of Trauma and Learning Policy Initiative’s (TLPI) Inquiry‐Based Process: Year Three. Boston, MA: Boston University, Wheelock College of Education and Human Development. Retrieved from
  8. Call, C., Purvis, K., Parris, S., & Cross, D. (2014, September) Creating trauma-informed classrooms. Adoption Advocate, 75. Retrieved from
  9. Purvis, K. B., Cross, D. R., Dansereau, D. F. & Parris, S. R. (2013, October) Trust-based relational intervention (TBRI): A systemic approach to complex developmental trauma. Child Youth Services, 34 (4), 360-386. Doi: 10.1080/0145935X.2013.859906
  10. Mounts, B. & Bradley, L. (2020)
  11. White, K. R. (2016)
  12. Kittle, K. & Reed, K. (2017).
  13. Liao, M. & Testa, M. (2016) Postadoption and guardianship: An evaluation of the adoption preservation, assessment, and linkage program. Research on Social Work Practice, 26(6), 675-685. doi: 10.1177/1049731514564600
  14. Kittle, K. & Reed, K. (2017)
  15. Mounts B. & Bradley, L. (2020)
  16. Green, S. (2016) The law demands process for rehomed children. Arkansas Law Review, 69, 729-755.
  17. White, K. R. (2016)
  18. Ibid.
  19. Kittle, K. & Reed, K. (2017)
  20. White, K. R. (2016), p. 385.
  21. Kittle, K. (2020, January 16) Launching your child into adulthood [Web log post]. Retrieved from:
  22. Brodzinsky, D. & Smith, S. L. (2019) Commentary: Understanding research, policy, and practice issues in adoption instability. Research on Social Work Practice, 29(2), 185-194. doi: 10.1177/1049731518782647
  23. Mounts, B. & Bradley, L. (2020) Issues involving international adoption. Therapy for Couples and Families, 28(1), 33-39. doi: 10.1177/1066480719887494
  24. Kittle, K. & Reed, K. (2017)
  25. Ibid.
  26. White, K. R. (2016) Placement discontinuity for older children and adolescents who exit foster care through adoption or guardianship: A systematic review. Child Adolescent Social Work Journal, 33, 377-394. doi: 10.1007/s10560-015-0425-1